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An Observational Study of BOTOX® as Headache Prophylaxis for Chronic Migraine

A 24-month, Prospective, Non-interventional Study to Describe the Long Term, Real-Life Use of BOTOX® for the Symptomatic Treatment of Adults With Chronic Migraine, Measuring Healthcare Resource Utilization, and Patient Reported Outcomes Observed in Practice

Status
Completed
Phases
Unknown
Study type
Observational
Source
ClinicalTrials.gov
Registry ID
NCT01686581
Enrollment
641
Registered
2012-09-18
Start date
2012-07-23
Completion date
2016-10-12
Last updated
2018-11-09

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Migraine Disorders

Brief summary

This is an observational study to describe the long term use of Onabotulinumtoxin A (BOTOX®) as prescribed by the physician for headache prophylaxis in adults with chronic migraine. All treatment decisions lie with the physician.

Interventions

DRUGbotulinum toxin Type A

Botulinum toxin Type A (BOTOX®) administered according to physician prescription.

Sponsors

Allergan
Lead SponsorINDUSTRY

Study design

Observational model
CASE_ONLY
Time perspective
PROSPECTIVE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

\- Prescribed BOTOX® for the prophylaxis of headaches.

Exclusion criteria

* Received treatment with any botulinum toxin Type A serotype in the last 26 weeks * Current participation in Allergan's Botox Chronic Migraine Post-Authorisation Safety Study (protocol 191622-110).

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants Admitted to the Hospital for HeadacheBaseline (previous 3 months prior to first dose of BOTOX®) and Last Follow-up Visit (FU last) [median 21.20 months]The Baseline value included participants who had been admitted to the hospital for headache in the last 3 months prior to the baseline visit (first administration of BOTOX®); the Last Follow-up value included participants who been admitted to the hospital for headache since the previous visit.
Mean Number of Days of Headache-related Hospital AdmissionsBaseline (previous 3 months prior to first dose of BOTOX@) to FU last [median 21.20 months]The number of admission days is presented as the mean, normalized to a period of 90 days. The Baseline value included admissions during the last 3 months prior to the baseline visit (first administration of BOTOX®); the Last Follow-up value included admissions since the second-to-last visit.
Percentage of Participants Who Visited Any Healthcare Professional (HCP)Baseline (previous 3 months prior to first dose of BOTOX®) to FU last [median 21.20 months]The Baseline value included participants who had visited an HCP in the last 3 months prior to the baseline visit (first administration of Botox); the value for FU last included participants who visited an HCP since the second-to-last visit.

Secondary

MeasureTime frameDescription
Change From Baseline in the Number of Headache DaysBaseline (prior to first dose of BOTOX®) to ADM last [median 20.30 months]At each visit, participants were asked to provide the number of headache days he/she experienced in the last month. A headache day was defined as 4 or more hours of continuous headache. A negative change from Baseline (less headache days) indicates improvement.
Change From Baseline in Migraine-Specific Quality of Life Questionnaire (MSQ) ScoreBaseline to Last Administration of BOTOX® (ADM last) [median 20.30 months]The MSQ is a 14-item questionnaire to measure health-related quality-of-life attributed to migraine in the past 4 weeks. Each item is scored on a 6-point scale where: 1=none of the time to 6=all of the time. There are 3 dimensions: Role-function Restrictive (questions 1 to 7; score range 7 to 42), Role-function Preventive (questions 8 to 11; score range 4 to 24) and Emotional-function (questions 12 to 14; score range 3 to 18). The individual dimension scores were converted to a score of 0 to 100; the total score ranged from 0 to 300 with higher numbers representing a better quality of life. A positive change from baseline in the dimension scores and the total score indicates that quality of life has improved.
Percentage of Participants With Good or Very Good Responses on the 4-Point Treatment Satisfaction ScaleADM last [median 20.30 months]At each visit, participants and physicians were asked to indicate the level of satisfaction that he/she had with the treatment. Physicians indicated the level of satisfaction with the patient's treatment. The 4- point scale consisted of the following responses: insufficient, moderate, good and very good. The combined percentage of good and very good responses by participants and physicians are reported.
Change From Baseline in the EQ-5D Questionnaire Total ScoreBaseline (prior to first dose of BOTOX®) to ADM last [median 20.30 months]The EQ-5D consists of 5 dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) assessed by the participant using a 3-point scale: 1=no problems, 2=some problems and 3=extreme problems. The combination of levels from the 5 dimensions results in a health state code. The total score is calculated by converting the health state code into a score: start with score 1.000=\[11111\] (perfect health state), subtract 0.081 (constant) for any other state, subtract nothing for level 1 on any dimension, subtract appropriate level 2 or level 3 value for each dimension from a table of constants \[Level 2: Mobility 0.069, Self-care 0.104, Usual activity 0.036, Pain/discomfort 0.123, Anxiety/depression 0.071\] \[Level 3: Mobility 0.314, Self-care 0.214, Usual activity 0.094, Pain/discomfort 0.386, Anxiety/depression 0.236\], subtract 0.269 if any dimension has a level 3 problem. Higher numbers indicate better health. A positive change from Baseline indicates improvement.
Change From Baseline in the Health State Score of the EQ-5D QuestionnaireBaseline (prior to first dose of BOTOX®) to ADM last [median 20.30 months]The EQ-5D health state scale is a visual analog scale that ranges from 0 (worst imaginable health state) to 100 (best imaginable health state), with higher scores indicating a better state of health. Participants were asked to rate their health state on a drawn line that started at 0 and ended at 100. A positive change from baseline in the health state score indicates that the participant's health state has improved.

Countries

Germany, Italy, Norway, Russia, Spain, Sweden, United Kingdom

Participant flow

Participants by arm

ArmCount
BOTOX®
BOTOX® (botulinum toxin Type A) administered according to physician prescription for the treatment of chronic migraine; all treatment decisions lie with the physician.
633
Total633

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyLack of Efficacy90
Overall StudyOther Miscellaneous Reasons36
Overall StudyParticipant Concerned about Risks6
Overall StudyReason Missing1
Overall StudySide-effects or Health Problems15
Overall StudyThinks Injections Take Too Much Time2
Overall StudyThinks Injections Too Painful8
Overall StudyThinks it is Inconvenient17
Overall StudyTrying to get Pregnant or Nursing2

Baseline characteristics

CharacteristicBOTOX®
Age, Continuous45.4 years
STANDARD_DEVIATION 11.7
Sex: Female, Male
Female
540 Participants
Sex: Female, Male
Male
93 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
0 / 633
other
Total, other adverse events
34 / 633
serious
Total, serious adverse events
8 / 633

Outcome results

Primary

Mean Number of Days of Headache-related Hospital Admissions

The number of admission days is presented as the mean, normalized to a period of 90 days. The Baseline value included admissions during the last 3 months prior to the baseline visit (first administration of BOTOX®); the Last Follow-up value included admissions since the second-to-last visit.

Time frame: Baseline (previous 3 months prior to first dose of BOTOX@) to FU last [median 21.20 months]

Population: Participants from the Safety Analysis Set, all participants who received at least one dose of BOTOX®, who were hospitalized.

ArmMeasureGroupValue (MEAN)Dispersion
BOTOX®Mean Number of Days of Headache-related Hospital AdmissionsBaseline8.9 daysStandard Deviation 20.14
BOTOX®Mean Number of Days of Headache-related Hospital AdmissionsFU last4.8 daysStandard Deviation 10.98
Primary

Percentage of Participants Admitted to the Hospital for Headache

The Baseline value included participants who had been admitted to the hospital for headache in the last 3 months prior to the baseline visit (first administration of BOTOX®); the Last Follow-up value included participants who been admitted to the hospital for headache since the previous visit.

Time frame: Baseline (previous 3 months prior to first dose of BOTOX®) and Last Follow-up Visit (FU last) [median 21.20 months]

Population: Participants from the Safety Analysis Set, all participants who received at least one dose of BOTOX®, with data available for analysis at the given time-point.

ArmMeasureGroupValue (NUMBER)
BOTOX®Percentage of Participants Admitted to the Hospital for HeadacheBaseline6.0 percentage of participants
BOTOX®Percentage of Participants Admitted to the Hospital for HeadacheFU last2.1 percentage of participants
Primary

Percentage of Participants Who Visited Any Healthcare Professional (HCP)

The Baseline value included participants who had visited an HCP in the last 3 months prior to the baseline visit (first administration of Botox); the value for FU last included participants who visited an HCP since the second-to-last visit.

Time frame: Baseline (previous 3 months prior to first dose of BOTOX®) to FU last [median 21.20 months]

Population: Participants from the Safety Analysis Set, all participants who received at least one dose of BOTOX®, with data available for analysis at the given time-point.

ArmMeasureGroupValue (NUMBER)
BOTOX®Percentage of Participants Who Visited Any Healthcare Professional (HCP)Any HCP Visit: Baseline45.8 percentage of participants
BOTOX®Percentage of Participants Who Visited Any Healthcare Professional (HCP)Any HCP Visit: FU last17.1 percentage of participants
BOTOX®Percentage of Participants Who Visited Any Healthcare Professional (HCP)Outpatient Consultation: Baseline33.3 percentage of participants
BOTOX®Percentage of Participants Who Visited Any Healthcare Professional (HCP)Outpatient Consultation: FU last6.8 percentage of participants
BOTOX®Percentage of Participants Who Visited Any Healthcare Professional (HCP)Accident and Emergency Visit: FU last2.6 percentage of participants
BOTOX®Percentage of Participants Who Visited Any Healthcare Professional (HCP)Alternative Practitioner: Baseline6.3 percentage of participants
BOTOX®Percentage of Participants Who Visited Any Healthcare Professional (HCP)Alternative Practitioner: FU last2.0 percentage of participants
BOTOX®Percentage of Participants Who Visited Any Healthcare Professional (HCP)Other: Baseline4.3 percentage of participants
BOTOX®Percentage of Participants Who Visited Any Healthcare Professional (HCP)Other: FU last0.5 percentage of participants
BOTOX®Percentage of Participants Who Visited Any Healthcare Professional (HCP)Primary Care Consultant Visit: Baseline30.6 percentage of participants
BOTOX®Percentage of Participants Who Visited Any Healthcare Professional (HCP)Primary Care Consultant Visit: FU last12.7 percentage of participants
BOTOX®Percentage of Participants Who Visited Any Healthcare Professional (HCP)Accident and Emergency Visit: Baseline6.3 percentage of participants
Secondary

Change From Baseline in Migraine-Specific Quality of Life Questionnaire (MSQ) Score

The MSQ is a 14-item questionnaire to measure health-related quality-of-life attributed to migraine in the past 4 weeks. Each item is scored on a 6-point scale where: 1=none of the time to 6=all of the time. There are 3 dimensions: Role-function Restrictive (questions 1 to 7; score range 7 to 42), Role-function Preventive (questions 8 to 11; score range 4 to 24) and Emotional-function (questions 12 to 14; score range 3 to 18). The individual dimension scores were converted to a score of 0 to 100; the total score ranged from 0 to 300 with higher numbers representing a better quality of life. A positive change from baseline in the dimension scores and the total score indicates that quality of life has improved.

Time frame: Baseline to Last Administration of BOTOX® (ADM last) [median 20.30 months]

Population: Safety Analysis Set, all participants who received at least one dose of BOTOX®, with data available for analysis at the given time-point.

ArmMeasureGroupValue (MEDIAN)
BOTOX®Change From Baseline in Migraine-Specific Quality of Life Questionnaire (MSQ) ScoreRole Function-Restrictive: Baseline (BL)37.14 score on a scale
BOTOX®Change From Baseline in Migraine-Specific Quality of Life Questionnaire (MSQ) ScoreRole Function-Preventive: Change BL to ADM last20.00 score on a scale
BOTOX®Change From Baseline in Migraine-Specific Quality of Life Questionnaire (MSQ) ScoreEmotional Function: Change from BL to ADM last26.67 score on a scale
BOTOX®Change From Baseline in Migraine-Specific Quality of Life Questionnaire (MSQ) ScoreRole Function-Restrictive: Change BL to ADM last25.71 score on a scale
BOTOX®Change From Baseline in Migraine-Specific Quality of Life Questionnaire (MSQ) ScoreRole Function-Preventive: Baseline50.0 score on a scale
BOTOX®Change From Baseline in Migraine-Specific Quality of Life Questionnaire (MSQ) ScoreEmotional Function: Baseline40.00 score on a scale
BOTOX®Change From Baseline in Migraine-Specific Quality of Life Questionnaire (MSQ) ScoreTotal Score: Baseline132.86 score on a scale
BOTOX®Change From Baseline in Migraine-Specific Quality of Life Questionnaire (MSQ) ScoreTotal Score: Change from BL to ADM last70.95 score on a scale
Secondary

Change From Baseline in the EQ-5D Questionnaire Total Score

The EQ-5D consists of 5 dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) assessed by the participant using a 3-point scale: 1=no problems, 2=some problems and 3=extreme problems. The combination of levels from the 5 dimensions results in a health state code. The total score is calculated by converting the health state code into a score: start with score 1.000=\[11111\] (perfect health state), subtract 0.081 (constant) for any other state, subtract nothing for level 1 on any dimension, subtract appropriate level 2 or level 3 value for each dimension from a table of constants \[Level 2: Mobility 0.069, Self-care 0.104, Usual activity 0.036, Pain/discomfort 0.123, Anxiety/depression 0.071\] \[Level 3: Mobility 0.314, Self-care 0.214, Usual activity 0.094, Pain/discomfort 0.386, Anxiety/depression 0.236\], subtract 0.269 if any dimension has a level 3 problem. Higher numbers indicate better health. A positive change from Baseline indicates improvement.

Time frame: Baseline (prior to first dose of BOTOX®) to ADM last [median 20.30 months]

Population: Participant from the Safety Analysis Set, all participants who received at least one dose of BOTOX®, with data available at the given time-point.

ArmMeasureGroupValue (MEDIAN)
BOTOX®Change From Baseline in the EQ-5D Questionnaire Total ScoreBaseline0.69 score on a scale
BOTOX®Change From Baseline in the EQ-5D Questionnaire Total ScoreChange from Baseline to ADM last0.107 score on a scale
Secondary

Change From Baseline in the Health State Score of the EQ-5D Questionnaire

The EQ-5D health state scale is a visual analog scale that ranges from 0 (worst imaginable health state) to 100 (best imaginable health state), with higher scores indicating a better state of health. Participants were asked to rate their health state on a drawn line that started at 0 and ended at 100. A positive change from baseline in the health state score indicates that the participant's health state has improved.

Time frame: Baseline (prior to first dose of BOTOX®) to ADM last [median 20.30 months]

Population: Participants from the Safety Analysis Set, all participants who received at least one dose of BOTOX®, with data available at the given time-point.

ArmMeasureGroupValue (MEDIAN)
BOTOX®Change From Baseline in the Health State Score of the EQ-5D QuestionnaireChange from Baseline to ADM last10.0 score on a scale
BOTOX®Change From Baseline in the Health State Score of the EQ-5D QuestionnaireBaseline50.0 score on a scale
Secondary

Change From Baseline in the Number of Headache Days

At each visit, participants were asked to provide the number of headache days he/she experienced in the last month. A headache day was defined as 4 or more hours of continuous headache. A negative change from Baseline (less headache days) indicates improvement.

Time frame: Baseline (prior to first dose of BOTOX®) to ADM last [median 20.30 months]

Population: Participants from the Safety Analysis Set, all participants who received at least one dose of BOTOX®, with data available at the given time-point.

ArmMeasureGroupValue (MEDIAN)
BOTOX®Change From Baseline in the Number of Headache DaysBaseline20.0 days
BOTOX®Change From Baseline in the Number of Headache DaysChange from Baseline to ADM last-11.0 days
Secondary

Percentage of Participants With Good or Very Good Responses on the 4-Point Treatment Satisfaction Scale

At each visit, participants and physicians were asked to indicate the level of satisfaction that he/she had with the treatment. Physicians indicated the level of satisfaction with the patient's treatment. The 4- point scale consisted of the following responses: insufficient, moderate, good and very good. The combined percentage of good and very good responses by participants and physicians are reported.

Time frame: ADM last [median 20.30 months]

Population: Participants from the Safety Analysis Set, all participants who received at least one dose of BOTOX®, with data available.

ArmMeasureGroupValue (NUMBER)
BOTOX®Percentage of Participants With Good or Very Good Responses on the 4-Point Treatment Satisfaction ScalePhysician Assessment78.1 percentage of participants
BOTOX®Percentage of Participants With Good or Very Good Responses on the 4-Point Treatment Satisfaction ScalePatient Assessment76.0 percentage of participants

Source: ClinicalTrials.gov · Data processed: Feb 22, 2026